Medicaid State Plan Amendments

Clarifies language for existing benefits, specifically as they relate to those under the age of 21. The amendment will align the Alternative Benefits Plan (ABP) with the changes to traditional Medicaid.

This amendment is proposing the following changes to the 1915(i) program: Increase the timeframe that a face-to-face psychosocial assessment must be completed or updated, expand participant eligibility, update the frequency for POC reviews and Child and Family Team meetings, and remove the separate reimbursement for telephonic peer support services and clarify that Family Peer Support Services can be provided in person and via AV and audio-only telehealth, and add coverage of Youth Peer Support Services.

This amendment is to increase its medically needy income level (MNIL).

This amendment modified the maximum amount allowed for the maintenance of a home of institutionalized beneficiaries to reflect the Social Security Cost-of-Living Adjustment (COLA).

The state memorialized the new income standards for its optional state supplement program, the beneficiaries of which are eligible for Medicaid under Wisconsin's State Plan.

This amendment proposed a resource disregard in order to increase the effective resource standards for all Medicaid eligibility groups subject to a resource test.

This Amendment updates state plan assurances in accordance with federally mandated quality reporting requirements for the Child Core Set and the behavioral health quality measures on the Adult Core Set as outlined in 42 CFR 431.16 and 437.10 through 437.15.

This plan amendment establishes a new class of supplemental payments to qualifying Medical Assistance (MA) enrolled acute care general hospitals that serve a disproportionate share of elderly individuals and relies on primarily government payers.

This plan amendment updates the Clinical Diagnostic Laboratory Services fee schedules (CDL), and removes language related to COVID-19 lab rates that is no longer relevant.

This amendment updates Medicaid State Plan language to ensure that responsible third-party payers (other than Medicare plans) are barred from refusing payment for an item or service solely because it did not receive prior authorization under the third-party
payer's rules.